McMillan Alexandra, Kocharyan Armine, Dekker Simone E, Kikano Elias George, Garg Anisha, Huang Victoria W, Moon Nicholas, Cooke Malcolm, Mowry Sarah E
Department of Otolaryngology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Ann Otol Rhinol Laryngol. 2020 Dec;129(12):1168-1173. doi: 10.1177/0003489420918273. Epub 2020 May 4.
To identify 3D-printed temporal bone (TB) models that most accurately recreate cortical mastoidectomy for use as a training tool by comparison of different materials and fabrication methods.
There are several different printers and materials available to create 3D-printed TB models for surgical planning and trainee education. Current reports using Acrylonitrile Butadiene Styrene (ABS) plastic generated via fused deposition modeling (FDM) have validated the capacity for 3D-printed models to serve as accurate surgical simulators. Here, a head-to-head comparison of models produced using different materials and fabrication processes was performed to identify superior models for application in skull base surgical training.
High-resolution CT scans of normal TBs were used to create stereolithography files with image conversion for application in 3D-printing. The 3D-printed models were constructed using five different materials and four printers, including ABS printed on a MakerBot 2x printer, photopolymerizable polymer (Photo) using the Objet 350 Connex3 Printer, polycarbonate (PC) using the FDM-Fortus 400 mc printer, and two types of photocrosslinkable acrylic resin, white and blue (FLW and FLB, respectively), using the Formlabs Form 2 stereolithography printer. Printed TBs were drilled to assess the haptic experience and recreation of TB anatomy with comparison to the current paradigm of ABS.
Surgical drilling demonstrated that FLW models created by FDM as well as PC and Photo models generated using photopolymerization more closely recreated cortical mastoidectomy compared to ABS models. ABS generated odor and did not represent the anatomy accurately. Blue resin performed poorly in simulation, likely due to its dark color and translucent appearance.
PC, Photo, and FLW models best replicated surgical drilling and anatomy as compared to ABS and FLB models. These prototypes are reliable simulators for surgical training.
通过比较不同材料和制作方法，确定能最准确重现皮质乳突切除术的3D打印颞骨（TB）模型，用作训练工具。
有几种不同的打印机和材料可用于创建用于手术规划和学员教育的3D打印TB模型。目前使用通过熔融沉积建模（FDM）生成的丙烯腈丁二烯苯乙烯（ABS）塑料的报告已经验证了3D打印模型作为精确手术模拟器的能力。在此，对使用不同材料和制作工艺生产的模型进行了直接比较，以确定在颅底外科手术训练中应用的优质模型。
使用正常TB的高分辨率CT扫描创建立体光刻文件，并进行图像转换以用于3D打印。3D打印模型使用五种不同材料和四台打印机构建，包括在MakerBot 2x打印机上打印的ABS、使用Objet 350 Connex3打印机的可光聚合聚合物（Photo）、使用FDM-Fortus 400 mc打印机的聚碳酸酯（PC），以及使用Formlabs Form 2立体光刻打印机的两种可光交联丙烯酸树脂，白色和蓝色（分别为FLW和FLB）。对打印的TB进行钻孔，以评估触觉体验和与当前ABS范例相比的TB解剖结构重现情况。
手术钻孔表明，与ABS模型相比，通过FDM创建的FLW模型以及使用光聚合生成的PC和Photo模型更接近地重现了皮质乳突切除术。ABS产生气味且不能准确呈现解剖结构。蓝色树脂在模拟中表现不佳，可能是由于其深色和半透明外观。
与ABS和FLB模型相比，PC、Photo和FLW模型最能复制手术钻孔和解剖结构。这些原型是可靠的手术训练模拟器。
